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Household Contamination of Baby Bottles and Opportunities to Improve Bottle Hygiene in Peri-Urban Lima, Peru

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dc.contributor.author Rothstein, Jessica D.
dc.contributor.author Mendoza, Alejandra Llican
dc.contributor.author Cabrera, Lilia Z.
dc.contributor.author Pachas, Jessica
dc.contributor.author Calderon, Maritza
dc.contributor.author Pajuelo, Monica J.
dc.contributor.author Caulfield, Laura E.
dc.contributor.author Winch, Peter J.
dc.contributor.author Gilman, Robert H.
dc.date.accessioned 2019-07-04T17:00:16Z
dc.date.available 2019-07-04T17:00:16Z
dc.date.issued 2019
dc.identifier.uri https://hdl.handle.net/20.500.12866/6823
dc.description.abstract Feeding of infant formula using contaminated bottles may be an important transmission pathway of enteric pathogens during early life. Determinants of suboptimal bottle hygiene and the feasibility and acceptability of intervention strategies have not been well assessed. We evaluated the extent of bottle contamination, its contributing factors, and options for promoting improved bottle hygiene in a Peruvian shantytown. During Phase 1, we sampled from bottles and caregiver hands (n = 48) and processed for enumeration of total coliform and Escherichia coli colony-forming units. A semi-structured questionnaire captured bottle use and hygiene practices. Phase 2 involved the identification of candidate practices to recommend to caregivers. Phase 3 consisted of a behavioral trial in which 14 caregivers were educated about improved practices for bottle disinfection and later reported on their experiences implementing them. Fecal bacteria were detected in 43.8% of bottles sampled during Phase 1 and in 21.7% of hands. Caregivers overall did not use effective methods for disinfecting bottles, displayed misunderstandings surrounding hygienic practices, and few had ever discussed bottle hygiene with a health provider. Findings from the behavioral trial indicated that the improved practice of brushing the bottle with dish detergent for 30 seconds after every use is preferable to boiling the bottle for several minutes daily as caregivers reported that the brush was simple to use, efficient, and practical. The promotion of a bottle brush and detergent is a feasible and acceptable intervention strategy in peri-urban settings, and future research should evaluate its long-term effectiveness for reducing bottle contamination. en_US
dc.language.iso eng
dc.publisher American Society of Tropical Medicine and Hygiene
dc.relation.ispartof urn:issn:1476-1645
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Article en_US
dc.subject bacterial count en_US
dc.subject bacterium contamination en_US
dc.subject bacterium detection en_US
dc.subject bottle hygiene en_US
dc.subject caregiver en_US
dc.subject cleaning en_US
dc.subject cohort analysis en_US
dc.subject coliform bacterium en_US
dc.subject colony forming unit en_US
dc.subject controlled study en_US
dc.subject detergent en_US
dc.subject disinfection en_US
dc.subject Escherichia coli en_US
dc.subject feasibility study en_US
dc.subject feces microflora en_US
dc.subject female en_US
dc.subject household en_US
dc.subject human en_US
dc.subject hygiene en_US
dc.subject infant en_US
dc.subject male en_US
dc.subject nonhuman en_US
dc.subject Peru en_US
dc.subject Peruvian en_US
dc.subject risk assessment en_US
dc.subject risk reduction en_US
dc.subject structured questionnaire en_US
dc.subject urban area en_US
dc.title Household Contamination of Baby Bottles and Opportunities to Improve Bottle Hygiene in Peri-Urban Lima, Peru en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.4269/ajtmh.18-0301
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.06 es_PE
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.06


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